ASOs strive to see more clients more quickly but, Parkland patients continue to wait months

Over the past year, the wait time to get an appointment at Parkland hospital’s Amelia Court appears to have gotten longer, although the staffing level appears to be about the same now as a year ago.

During that same time, community-based AIDS agencies in Dallas say they have expanded services and decreased wait times.

For new Parkland patients, the time from first contact to seeing a doctor can be as short as two weeks. But new patients trying to access services at the public clinic recently have reported waits of as long as four months.

Candace White, Parkland media spokeswoman, said that the clinic is taking new patient appointments as early as February and through March 1. She said she confirmed that with Sylvia Moreno, the hospital’s director of HIV services.

White attributed the delay to an increase in the number of patients accessing the clinic’s services due to successful HIV testing efforts throughout Dallas County. Some of the longer wait times quoted over the past few weeks may have been due to the holiday, she said.

However, when a Dallas Voice staff member called Amelia Court on Tuesday, Jan. 10, to make an appointment, he was transferred to voicemail to leave a message. As of deadline time on Thursday, Jan. 12, more than two days later, no one from the clinic had returned the call.

Another caller to Amelia Court was told that those February and March appointments White cited are reserved for established patients only. The next available appointment for first intake for new clients who want access to Amelia Court is April 23, the caller was told.

The Ryan White CARE Act, which funds many of the treatment programs for persons with HIV, specifies patients must receive “access to care within three weeks of presenting,” Dr. Gary Sinclair, former medical director of Amelia Court, said.

While he was at Amelia Court, Sinclair said that he and his staff reduced the waiting time to access medical care to two weeks. He left UT Southwestern and Parkland two years ago and is now an independent consultant involved in covering for physicians for Ryan White programs.

For years, all Parkland primary AIDS care was done at Amelia Court, located on Harry Hines Boulevard, a block from the main hospital. However, to relieve overcrowding at Amelia Court, doctors with experience in treating people with the virus have been seeing patients at three of the hospital’s Community Oriented Primary Care facilities in Dallas.

Parkland began opening the COPCs in 1987 to relieve its main emergency room of treating non-emergency cases.

The clinics were designed to provide convenient and affordable healthcare throughout Dallas County.

HIGH RISE CLINIC | Amelia Court’s HIV services will move to the new Parkland Hospital under construction across Harry Hines Boulevard from the old facility. (DavidTaffet/Dallas Voice)

Some of the facilities also have specialties. Two clinics — Bluitt-Flowers Health Center in South Dallas and Southeast Dallas Health Center in Pleasant Grove — were designated as HIV treatment sites.

A third — deHaro-Saldivar Health Center in Oak Cliff — previously treated adolescents and young adults with HIV, but that service has been discontinued.

Parkland’s clinic has been staffed at about the same level for the past several years.

But as HIV has changed to a manageable chronic illness, Sinclair said that there has been “a normalization of care.”

That normalization may include longer waiting times for appointments at the public hospital, something that is common in other specializations.

But while Parkland strives to keep the wait time for primary care down, some local agencies that provide clinical service to people with HIV at low or no cost say they have expanded their service and will see new patients quickly.

“On a very human level, it can be quite terrifying to want and need medical care and not be able to find it,” AIDS Arms Executive Director Raeline Nobles said. “AIDS Arms built its second HIV clinic to help with these exact problems in significant and positive ways.”

The agency opened Trinity Health & Wellness Clinic in Oak Cliff this past fall and continues operating Peabody Health Center in South Dallas. Both offer full primary care for people with HIV.

AIDS Arms accepts Medicare and Medicaid as well as private health insurance. And like the county hospital, medical care is free for low-income people without any coverage and is provided on a sliding-scale for others.

Intake takes about a week to complete, Nobles said. Once a person who has an HIV-positive diagnosis is registered as a client, doctors at Trinity Clinic can see a new patient that week.

“With fast access to medical appointments at our Trinity and Peabody clinics and five licensed providers, we are a partner in the solution to very large and disturbing access to care problems in our community,” Nobles said.

The agency is seeking to expand the services it offers its patients and is currently looking for specialists in ophthalmology, cardiology and renal care to supplement its care.

In addition, AIDS Arms is involved in drug research trials, something Amelia Court no longer does.

Sinclair said he believed that was part of a shift in federal research dollars away from “’How do we treat people?’ to ‘How do we eliminate the epidemic?’”

In addition, AIDS Arms is offering several new services to its patients at its Trinity clinic.

Legal Hospice of Texas will soon begin providing on-site legal assistance for disability, social security and HIV-related discrimination issues. Bryan’s House will be providing free childcare for patients visiting the clinic on Thursday and Fridays beginning next week. And once a week, onsite psychotherapy services will be offered.

Resource Center Dallas offers a variety of specialized medical services at its Nelson-Tebedo Community Clinic on Cedar Springs Road. Dental care is the most frequently accessed and something not provided by other agencies or Parkland.

With a recent expansion of facilities at the clinic, RCD Communications and Advocacy Manager Rafael McDonnell said the wait time for an appointment is three weeks or less. He said the clinic is able to treat emergencies even more quickly.

This article appeared in the Dallas Voice print edition January 13, 2012.